The hemodynamic effects of ketofol versus fentanyl-propofol in neurosurgical operations

Background : Anesthesia for neurosurgical patients aims to maintain stable hemodynamics, cerebral perfusion pressure (CPP), appropriate cerebral oxygenation, and relaxed brain to facilitate surgical procedures. Objectives: evaluate the relative merits of fentanyl-propofol and ketofol as neurosurgical induction and maintenance anesthetics. Study design: The study was prospective, randomized, and double-blind, and forty adults took part. Method: xFor elective neurosurgery procedures, 40 patients were randomly assigned to one of two groups and given general anesthesia. For induction and maintenance of anesthesia, one group received a mixture of ketamine and propofol, while the other group received a combination of fentanyl and propofol. Both groups had their intraoperative hemodynamic stability monitored. Results: ketofol (Group A) combination produced a significantly greater stability in pulse rate and in mean arterial pressure as compared to fentanyl (Group B) after induction of anesthesia (P=0.037) , (P=0.023) respectively and intraoperatively. Conclusion: Improved hemodynamic stability during induction and maintenance anesthesia without a rise in intracranial pressure is achieved with ketofol combination compared to fentanyl-propofol.